Awareness of human papillomavirus after introduction of HPV vaccination: a large population-based survey of Scandinavian women

Abstract

Using a large, population-based survey, we assessed the levels and correlates of human papillomavirus (HPV) awareness among Scandinavian women after introduction of HPV vaccination. In 2011-2012, a random sample of women aged between 18 and 45 years from Denmark, Sweden and Norway received a questionnaire on lifestyle, health and HPV awareness. We included 47 895 women (response rate 60.6%) in our study. Country-specific and age-specific proportions of women who had heard of HPV in 2011-2012 (postvaccination survey) were compared with corresponding proportions in an identical survey from 2004-2005 (prevaccination survey, n=54 079, response rate 71.3%). Correlates of HPV awareness in the postvaccination survey were assessed by logistic regression. In all countries and age groups, awareness of HPV increased from the prevaccination to the postvaccination survey. In the postvaccination survey, HPV awareness was higher in Denmark (75.8%) and Sweden (74.8%) compared with Norway (62.4%), with greatest discrepancy among women aged between 18 and 19 years (Denmark: 74.9%, Sweden: 70.4%, Norway: 39.6%). Variables associated with low HPV awareness included the following: low education [≤12 vs. >16 years of schooling: odds ratio (OR)=0.45, 95% confidence interval (CI): 0.42-0.48], being a virgin (vs. nonvirgins: OR=0.74, 95% CI: 0.66-0.83), never having used condoms (vs. ever: OR=0.62, 95% CI: 0.56-0.67), nonuse of contraception at first intercourse (vs. use: OR=0.83, 95% CI: 0.79-0.88) and daily smoking (vs. never: OR=0.86, 95% CI: 0.80-0.92). HPV awareness in Scandinavia has increased since the introduction of HPV vaccination. However, 24-38% of Scandinavian women still have never heard of HPV. Future information efforts should target groups with low HPV awareness.

Cervical Cancer, Human Papillomavirus Infection, and Vaccine-Related Knowledge

“…Numerous previously reported surveys have demonstrated that 50% to 85% of women know about cervical cancer in Asia, 17,18 which is in accordance with the observations of our study. Human papillomavirus awareness was higher in Denmark (75.8%) and Sweden (74.8%) compared with Norway (62.4%) and Senegal (63%), 19,20 while studies from Yunnan, China (52.6%), Xinjiang, China (0.14%, 10 out of 7100), and Brazil (37%) have reported low levels of knowledge and awareness about HPV that are consistent with the findings of this study. 13,21,22 However, the levels of knowledge and awareness about HPV observed in the present study are higher than those in previously reported studies 13,23 but are still low.…”

Awareness and attitude towards human papillomavirus and its vaccine among females with and without daughter(s) who participated in cervical cancer screening in Shenzhen, China

“…As the knowledge of HPV and its vaccine is pivotal for HPV vaccine promotion [22], identifying the factors associated with awareness thereof is vital to effectively to raise awareness about HPV infection and the benefits of HPV vaccination among targeted populations. We identified predictors of HPV and HPV vaccine awareness that were concordant with findings reported in previous studies, namely age [18,20,23], education level [17-20,23-,25], income level [18,23], age at sexual debut [24] and number of sexual partners [23,24]. Being the mother of a daughter was also associated with high HPV awareness [20].…”

Determinants for Participation in Human Papillomavirus Self-Sampling among Nonattenders to Cervical Cancer Screening in Denmark

“…A previous study based on the "health belief model" (45) found that women's willingness to participate in HPV self-sampling was influenced by their perceived self-efficacy to take the sample correctly; their understanding of the link between HPV and cervical cancer; and their perception of the benefits of and barriers to self-sampling (46). Thus, our observation that women with low education were less likely to self-sample might be due to lower self-efficacy to perform self-sampling or lower awareness of the benefits of cancer screening (47,48). Moreover, socioeconomically disadvantaged groups and women with severe mental illness may experience a challenging everyday life, which could potentially result in decreased capacity to participate in preventive care, even when offered a free-of-charge and convenient screening method such as self-sampling.…”